Talking to your Teen about Mental Health

Talking to your Teen about Mental Health

You are considering talking to your teen about his or her mental health (which includes emotions and behaviors) and are not sure about what approach to take or what to say.  Often this conversation arises when you or someone in your teen’s life is concerned about something in the teen’s emotions and behaviors.  As such this may or may not be an easy conversation to have but one that you should have.  You are probably aware that in our society there is a detrimental stigma around mental health, to the point that many people are hesitant to seek help, while many others never do.  It is important to normalize these conversations; talking about mental health should be as “normal” as talking about physical health. 

Mental health is part of your overall health, and it changes throughout our lives depending on our internal (I.e. genetics, coping skills) and external (i.e. environment, stress, trauma) factors.  Simply said, mental health is about: How one feels, thinks, and acts (these are interconnected).   More specifically, mental health is about the thoughts and feelings you have about yourself and others, thoughts and feelings you have about your past and future, what coping skills you have and use, what behaviors you engage in (including how you cope with the ups and downs of life) and so forth. 

Despite numerous campaigns geared to end stigma around mental health in the last decades, the truth is that if you ask the average person about mental health, chances are they do not know much about the facts and/or some may not even be comfortable having a conversation about it.  By having conversations about mental health with your teen, you are ensuring that he or she has the opportunity to dispel misconceptions and stigma, while also providing him or her with the information and resources he or she may need.  

We all have ways in which we deal with stress or difficult times.  The thoughts we have and what we do in our efforts to get through a difficult time is called coping.  We can all learn more and healthier ways of coping, which will make stressful situations easier to deal with.  Sometimes our coping can involve engaging with other people.  An important step in this process will be for you and your teen to explore and identify his or her support system which should be made up of individuals (i.e. parents, teacher, family member, counselor) and coping skills (i.e. relaxation skills, breathing techniques, problem solving, etc.) that he or she can use to deal with a difficult event that overwhelms them or a psychiatric disorder (such as anxiety, depression).  By identifying and discussing a support system your teen will be aware of his or her choices and know that they can seek support from you and from other reliable adults.  And, this will make it easier for your teen to come up with a plan were the need arise

An effective approach to take when speaking to your teen is Non-judgmental communication, which includes judging something as neither good nor bad, and focusing on just the facts.  As social animals, we are natural inclined and environmentally conditioned to make judgments, it is a primitive survival skill.  So it is not a matter of who judges but how much and how doing it impacts us, negatively or positively.  Many times making misinformed, miscalculated, and impulsive judgments can get in the way of progress.  

The first step to non-judgmental communication, is to become aware of your own self judgments.  It is very difficult to change a behavior if you are unaware you are doing the behavior. 

What are the differences between judgmental between non-judgmental self-talk? 

Judgmental: I had a poor grade in my last math test. I’m bad at math, I’m such a loser.

Non-judgmental (describing what you observe, facts): I had a 70 in my last math test. I got a lower score than I would have liked. I feel sad and disappointed. 

What differences did you notice? In the first we are attaching labels (poor, bad, loser) to ourselves, not describing the event or feelings.  Non-judgmental communication- will outline the facts, i.e. got 70, lower than I would have liked, feelings- sad and disappointed but IT IS NOT assigning labels and generalizing terms “I’m” (as if one event or action makes who you are).  Now read the statements again and think about how each thought makes you feel.  Some differences huh?  

Part of non-judgmental stance is to become aware of your own judgement but without judging, “it just is”, see it for what it is.  Once you catch yourself judging, accept the judgment (again: “don’t judge yourself for judging”), and then reframe your judgment into a statement focusing on describing the facts.  You can practice bringing your attention to your thoughts and judgments when you are doing simple activities i.e. eating and walking, and you’ll notice that with practice you can become more aware of your thoughts. 

It is also helpful to identify certain common judgmental words and phrases that you use and those that others may use that trigger you.  Frequently used judgmental words include (note that these can be “negative” or “positive”, the point is that they are based on one’s individual judgements, not necessarily on facts): “should,” “shouldn’t,” “stupid,” “wonderful,” “perfect,” “bad,” and “terrible.”  Something else to be mindful of is: how and when you use generalizing words which include: “always”, “never”; these often carry negative feelings and are not based on all the facts.  For example, “I always screw things up with my partners” (Upon closer inspection you may realize that although you’ve done somethings you wish you had done differently, you haven’t “always” acted that way).  Do you say things like “I always _______”, “I never_____”, and things like “I’m so ______ (stupid, lazy, weak)?  Now you are aware, now you can change.

Without judging yourself, turn that self-judgment into a nonjudgmental descriptive statement, describing the situation and the feeling you had.  Example: When X happens (Describe the situation), I feel X. (Use a feeling word- happy, sad, afraid, angry, disgusted etc.)  Example: “When I make a mistake, I feel anxious.”  

It is challenging to maintain a non-judgmental stance during times of stress and crisis, but it is possible. If you are feeling nervous, anxious, ambivalent, as you prepare to have this conversation with your teen, you may want to engage in relaxation activity, one of these could be a deep breathing exercise (coping skill). Bringing focus to your breathing helps you calm, relax and slow down your thinking so you can be more successful in having that non-judgmental talk.  You could breathe in as you mentally count (i.e. to 4) and breathe out longer breaths (mentally counting to i.e. up to 8).   Can repeat this until you feel calmer.  Focusing on your breathing allows you to be able to get in touch with your thinking in the present moment.

So now let’s think about a possible scenario: Your 13-year-old has not been cleaning his or her room, attained mostly 60s (D) and 70s (C) in the latest report card, and is going into the bedroom from the moment he or she gets from school until dinner.  Read the following, find judgments, think about the feeling you have after reading each, and pick the non-judgmental approach: 

“You are not focusing on your grades and your cleanliness, if you keep being like this you’re going to fail your classes, you’re wasting time and you’re not even spending time with your friends.”

“I want to remind you that we have rules in the house, everyone has tasks, and you are ignoring that you have chores, your grades are down, and you’re always in your room.”

“I wanted to talk to you about some things that I have noticed. I have noticed that your clothes are on the floor, there is food and dirty dishes in your room, your grades are lower compared to last semester’s, and you seem to be spending more time than usual in your room.” 

#3 is a Non-Judgmental approach, describing facts i.e. behaviors in a non-accusatory and neutral manner.  

When having the conversation, you may start with asking your teen how he or she is feeling, and if there is anything they would like to talk about.  And you may want to probe- (“Do you have an idea as to what I would like to talk to you about?”).  “What”, “How”, “Why” questions are more likely to lead to more open discussions than “Do” i.e.  Do you know what Y means? (this could end in “Yes” or “No” answers).  After a “yes” or “no” you can still follow up with “How come?”, “tell me more”, “could you explain”.  If your teen asks a question about a particular mental health topic or other, and you do not know the answer, it is okay to say “I don’t know the answer to that question, how about we find out together?” and you may also probe “I don’t know the answer but while we find out, what do you think the answer is?” (this may help explore myths and misconception you and your teen may have). 

Also, the best time to discuss your teen’s mental health, is not in the midst of a heated argument.  At such  times, it may not be easy for your teen or yourself to identify and effectively express thoughts and feelings. Taking some time to calm down, reflect, and identify thoughts and feelings is helpful.  

There is another component that you may have noticed in the nonjudgmental example, it starts with “I” but note that not all communication that starts with “I” is nonjudgmental (see example #2 above).  “I” messages help communicate effectively as we are able to share our thoughts and emotions in a clear and assertive way, due to this, “I” messages are commonly encouraged in family therapy.  “I” messages are a way of expressing thoughts and emotions using a neutral voice, i.e. “I __(feel)…because”, “I’m____(concerned) because”______”.

Statements that begin with “you” tend to evoke an escalation of emotions (usually discomforting ones i.e. shame, anger, resentment, fear, sadness etc.) and defensiveness. On the other hand, “I” messages tend to de-escalates defensiveness by telling the listener that what is being said is based on your personal experience thus making room for discussion. 

Examples of “I” Statements:

I think ____(your thoughts about the situation) And I feel _______ (state an emotion rather than a thought, for example: sad, angry, happy, concerned, etc.) because _____ (the specific reason you are feeling this way, with examples). I want ____ (provide a suggestion that you think could resolve the situation). 

I found this emotion list very helpful: http://thework.com/sites/thework/downloads/worksheets/Emotions_List_Ltr.pdf 

Now let’s say your teen is often (i.e. more than half the week) yelling at you and his sibling, slamming his bedroom door when you attempt to talk, has been caught smoking Marijuana and is failing his classes.  When you are upset you may think about or say something like “That’s it”, “What’s wrong with you!” ; “You are so disrespectful”, “You have totally lost it”, “That’s it, you are going to a therapist!” and so on, but will this get your teen to open up about what might be happening with him or her? Most likely not. 

What’s the most effective way to approach him?  One way with “I” statement would be something like: “I feel concerned because you seem upset, sometimes you yell at me and at your sister, like yesterday when I reminded you about basketball tryouts.  I would like for us to talk and find out if there’s anything I can do to help.” 

Although it may not seem so now, you may know your teen better than anyone else.  Think about the recommendations shared here and apply them as you think fitting to your teen.  You will have to pace the content and depth according to the progression of your conversation.  Remember that even a small step is progress and that although it may not seem so that teenage years are temporary!

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